Canada’s blood services stuck in the 90s on AIDS policies

Canada has a long history of cutting-edge medical innovation. Canadian school children learn about Dr. Frederick Banting and his discovery of a way to produce insulin, but Canadian scientists and researchers have also been responsible for breakthroughs in stem cell research, radiation treatments for cancer, and techniques for open-heart surgery.

Our record of accomplishment when it comes to evidence-based medical advances is long. That makes it all the more strange when a bit of incomprehensible backwardness shows up in Canadian medical policy. Like, for example, Canadian Blood Services and Héma-Québec’s continued ban on blood donations from men who have sex with men.

It’s hard to remember, 30 years on, the stifling terror of those early days of the AIDS epidemic. For those of us too young to have lived through it, we have to depend on the memories of people who were there.

Books like “And the Band Played On,” by Randy Shilts, or this year’s movie “The Normal Heart,” recall those early days when a mystery disease was picking off members of communities that were still heavily stigmatized. At that time, the disease was known by names like “Gay-Related Immune Deficiency,” or “the 4H disease” after what doctors perceived to be its main victims: homosexuals, Haitians, heterosexual intravenous drug users, and hemophiliacs.

AIDS was a disease that stayed mysterious for longer than it should have, in large part because deeply engrained homophobia slowed government action at a time when it was most needed.

Flash forward 30 years, and the context of AIDS research and innovation is almost unrecognizable.

Last year, funding for HIV/AIDS programs in low- and middle-income countries totaled approximately $19.1 billion dollars. Celebrities like Bono and Alicia Keys donate their fame to help raise funds for the cause, and the Bill and Melina Gates Foundation has made HIV/AIDS programs a pillar of its work.

AIDS is a disease that is now high-profile and well-funded. There’s still no cure, but HIV is also no longer a death sentence. It’s a manageable chronic condition – one that we can test for, and take precautions against.

And yet, Canadian Blood Services and Héma-Québec still maintain an inexplicable ban on blood donations from men who have sex with men.

To be fair, the policy is better than what it once was. Until July 22 of last year, there was a ban on blood from any man who had had sex with any other man since 1977 – no exceptions. The new policy only bans donations from men who have had sex with any other man within the last five years.

Supposedly, this is to protect recipients from potentially HIV-infected blood – an indisputably laudable goal, and one that is rightfully a top priority for Canadian blood banks.

But the idea that HIV is mainly transmitted through sex between men was discredited ages ago. It’s not the gender of the people involved that’s a risk – when it comes to sexual transmission, unsafe sexual practices are the problem, not the gender of the people involved.

That’s one of the reasons why women account for nearly a quarter of all new HIV infections in Canada – a demographic notably untouched by the current ban on blood from men who have sex with men.

While Canadian Blood Services and Héma-Québec’s policies have become more progressive, they still serve as a functional ban on donations from sexually active gay and bisexual men. It’s unrealistic to expect anyone to go celibate for five years, just to become a blood donor. And so the ban persists – regardless of any actual risk these men would pose as donors.

For people who came of age after AIDS erupted into the public consciousness, safer sex practices are a normal part of life. That’s especially true in the LGBT community, which suffered such devastating losses from AIDS. As a result, there are many gay and bisexual men who take exceptional care when it comes to sexual safety – while, of course, there are plenty of women and straight men who are far less careful. This policy doesn’t take those realities into account.

There is some evidence that lifting the ban on blood donations from men who have sex with men could result in a slightly higher risk of HIV transmission through blood transfusions. But basing policy on behaviour, rather than identity, would still make more sense. For instance, if you’re a woman, and one of your male sexual partners has had sex with men, your donation would only be subject to a temporary deferral – but your partner would still be banned from donating for five years from his last sexual encounter with a man. Both people in that situation would be at similar risk, but one would be subject to a five-year ban; the other would not.

Countries like Australia, Japan, and the UK have shortened their deferral periods for men who have sex with men to only one year; another 10 countries, including Italy and Spain, require no deferral period at all.

On Sunday, the Young Liberals launched a petition to pressure Canadian Blood Services and Héma-Québec into changing their policies. It’s a worthwhile initiative, if not one that makes for front-page news. A political organization launching a petition is not exactly a surprise.

The real news is that, in 2014, Canada’s blood banks are still depending on tired stereotypes to screen their donors.

Canada’s blood supply has just hit a six-year low; Canadian Blood Services put out a call on Monday begging for more donors. Studies in the United States have shown that lifting the ban on blood from men who have sex with men would save lives, and bring in almost 300,000 more litres of blood per year. And yet, Canada’s blood banks are still turning away willing donors.

Canadian Blood Services and Héma-Québec are medical services. They should be making policy based on science, rather than stereotypes – Canadians’ lives depend on it.

—Devon Black is studying law at the University of Victoria. In addition to writing for iPolitics, Devon has worked for the Canadian International Development Agency, Leadership Africa USA and RamRais & Partners.

The views, opinions and positions expressed by all iPolitics columnists and contributors are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of iPolitics.

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